Microbiome Cross-Talk in COPD: Insights into the Gut?Lung Axis and Emerging Treatments
Author(s): Anastasia V. Poznyak*, Alexander L. Golovyuk, Aleksandra Sergeevna Utkina, Elizaveta Romanovna Korchagina, Olga Nikolaevna Maltseva and Alexander N. Orekhov
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disease characterized by persistent inflammation, declining lung function, and a high global burden of disease. In addition to classic risk factors such as smoking and genetic predisposition, mounting evidence highlights the critical role of the gut-lung axis in the pathogenesis of COPD. Alterations in the gut and lung microbiota disrupt immune homeostasis, reduce barrier integrity, and increase systemic inflammation, thereby influencing the onset, progression, and exacerbations of the disease. Cross-talk between microbial communities occurs through the trafficking of immune cells, microbial metabolites such as short-chain fatty acids, and host gene regulation mechanisms, including epigenetic and inflammasome pathways. Clinical and preclinical studies also suggest that diet, probiotics, bacteriophages, fecal microbiota transplantation, and traditional herbal formulations can restore microbial balance and provide therapeutic benefits. However, the practical application of these approaches remains limited due to fragmented data and a lack of large-scale studies. This review summarizes current knowledge on microbiome interactions in COPD, explores the molecular mechanisms underlying gut-lung interactions, and highlights new microbiome-based strategies that have the potential to transform disease prevention and treatment.
